Okay, it looks like the public option folks have their work cut out for them, explanation wise. It just doesn't make sense to me. I've been reading these plans and I see a LOT of gotchas, compared to single payer.. For example, I see so many people bitching about COBRA and wanting public option. If a public option takes two or three years to kick in, at current rates of cost increase, that price will be comparable to COBRA's cost for a similar plan, NOW.
One trillion dollars over ten years for subsidies sounds like a lot of money, it is. Its $322 per American, per year, if the population does not grow, and there is not any inflation. (doubly unlikely)
So, obviously, people who have incomes, wont be receiving a lot of subsidies under public option. The plans will have to be self supporting, so they have limited options. people starting out at birth without chronic illness are going to need Health Savings Accounts and start saving when they are infants, in case they get sick. Alternatively the premiums to purchase insurance that protects them adequately are going to be very high.
First, the rates.. How dumb do they think we are? VERY..
DON'T the poor hopeful people see that any UNSUBSIDIZED public option's premiums will have to be basically very similar!? Do they think that if they make less than 3x FPL, they will get 100% subsidy? NO. Do they think healthcare rates will stoip rising? NO.. Do they think that public option will save money SO much- NO - at the very best case (which I don't think is possible) it would be maybe two or three years behind COBRA premiums in terms of cost- Thats if we're lucky- because basically, the dynamics are similar, (except for public option's much sicker risk pool- SEE THE PROBLEM!?) YES, given the skyrocketing rate of increase in medical costs, I think its realistic to say that public option plans will cost around what an UNSUBSIDIZED (thats before the recent short-lived subsidies for COBRA) COBRA plan did around two years before it. (insurance costs have been going up as much as 15 percent a year for many companies)
Health Savings Account?
Whenever you sell somebody high deductible insurance, you HAVE to also impress upon them the SUPREME IMPORTANCE of taking the thousands of dollars a year that they are saving by buying that high deductible catastrophic insurance and putting it in an HSA.
Why?
BECAUSE THEY ONLY COVER A PORTION OF THE ACTUAL MEDICAL COSTS YOU END UP WITH.
Now, when these "catastrophic" insurance plans first came out, there was a LOT of talk about HSAs, but in the last decade or so, as wages have fallen and insurance takes more and more, people seem to have forgotten that CATASTROPHIC INSURANCE IS NOT FOR PAYING THE DAY TO DAY MEDICAL COSTS, its sort of, well, ONLY FOR catastrophes.. and you jolly well better have money in the bank to cover your co pays and deductibles or, zap, your cots are so high, you don't have money to cover both them AND your premium, so then, zap, you pay the cost for the drug you need, and zap, then you are left without insurance again because you missed a a payment!
That is hppening to a lot of people in California's high risk pool. Their "public option" as it were.
"We don't advertise the program because we can't handle everyone who comes to us already," said Lesley Cummings, executive director of the state's Major Risk Medical Insurance Board, which oversees MRMIP." (Major Risk Medical Insurance Program)
I guess what I am asking is with the already far sicker than average public option, what happens if the uncovered costs are so high you miss payments..
I have lots of other questions too.. You should too.
Realize that the health insurance industry are experts at making the press see things their way. So is the Obama administration, which wants to both satisfy their major investors and lower the government's healthcare costs. the people are a distant third.
Here's another one.. Looking at the new Common Cause report on "legislating under the influence", I was struck by the high amounts of money being paid to many of our legislators on these public option like issues.
Obviously these huge contributions effect their votes on issues like health insurance and pharmaceutical purchasing.
For example..look at the huge amounts contributed to the 20 top Senators..
Top 20 Senate recipients of health industry campaign contributions, 2000-2008. Legislating Under the Influence: Table 2a
|
Senator | Affiliation | Committee or Leadership? | Total | Health Insurance | Health Professionals | Health Institutions | Pharm & Health Products |
---|
Arlen Specter | (D) | No | $7,298,512 | $1,208,716 | $2,591,066 | $1,435,790 | $2,062,940 |
Blanche Lincoln | (D) | Yes | $6,289,814 | $1,410,138 | $2,277,968 | $1,281,062 | $1,320,646 |
Joe Lieberman | (I) | No | $5,900,388 | $1,836,988 | $1,968,770 | $727,550 | $1,367,080 |
Orrin G Hatch | (R) | Yes | $5,589,860 | $1,002,556 | $1,142,492 | $816,410 | $2,628,402 |
Sherrod Brown | (D) | Yes | $5,045,340 | $241,225 | $3,882,188 | $503,927 | $418,000 |
Saxby Chambliss | (R) | No | $4,442,891 | $1,283,026 | $1,983,419 | $481,400 | $695,046 |
Richard Burr | (R) | Yes | $4,216,022 | $821,902 | $1,767,561 | $391,382 | $1,235,177 |
Chris Dodd | (D) | Yes | $3,339,508 | $2,067,708 | $515,900 | $212,250 | $543,650 |
Ben Cardin | (D) | No | $3,142,865 | $569,175 | $1,635,076 | $569,550 | $369,064 |
Max Baucus | (D) | Yes | $2,604,524 | $669,284 | $799,964 | $466,591 | $668,685 |
Jim Bunning | (R) | Yes | $2,589,660 | $932,462 | $1,031,958 | $291,740 | $333,500 |
Mitch McConnell | (R) | Yes | $2,442,465 | $614,277 | $958,853 | $427,350 | $441,985 |
Jim DeMint | (R) | No | $2,347,704 | $582,806 | $1,386,848 | $272,150 | $105,900 |
Lindsey Graham | (R) | No | $2,287,153 | $493,427 | $1,090,909 | $332,773 | $370,044 |
Robert Menendez | (D) | Yes | $2,252,169 | $529,950 | $758,369 | $240,300 | $723,550 |
Mark Udall | (D) | No | $2,177,912 | $378,482 | $1,044,755 | $209,375 | $545,300 |
David Vitter | (R) | No | $1,982,757 | $294,430 | $1,384,825 | $188,702 | $114,800 |
Johnny Isakson | (R) | Yes | $1,945,099 | $478,292 | $891,611 | $150,400 | $424,796 |
Tom Harkin | (D) | Yes | $1,827,848 | $162,690 | $924,494 | $241,075 | $499,589 |
Roger Wicker | (R) | No | $1,766,044 | $451,800 | $803,999 | $236,350 | $273,895 |
a similar situation exists in the House
Top 20 House recipients of health industry campaign contributions, 2000-2008. Legislating Under the Influence: Table 2b
|
Name | Affiliation | Committee or Leadership? | Total | Health Insurance | Health Professionals | Health Institutions | Pharm & Health Products |
---|
Frank Pallone, Jr | (D) | Yes | $2,916,718 | $110,500 | $2,152,991 | $282,199 | $371,028 |
Ron Paul | (R) | No | $1,965,738 | $192,260 | $1,378,732 | $217,334 | $177,412 |
Charles B Rangel | (D) | Yes | $1,876,646 | $434,319 | $681,074 | $371,853 | $389,400 |
John D Dingell | (D) | Yes | $1,701,258 | $154,800 | $831,424 | $138,200 | $576,834 |
Earl Pomeroy | (D) | Yes | $1,699,117 | $815,577 | $554,225 | $213,316 | $115,999 |
Roy Blunt | (R) | Yes | $1,690,433 | $360,025 | $732,216 | $185,126 | $413,066 |
Joe Barton | (R) | Yes | $1,679,714 | $122,550 | $786,098 | $180,134 | $590,932 |
Eric Cantor | (R) | Yes | $1,508,544 | $476,000 | $535,025 | $218,619 | $278,900 |
Phil Gingrey | (R) | No | $1,476,563 | $117,370 | $1,191,994 | $63,800 | $103,399 |
Phil English | (R) | Yes | $1,399,692 | $273,158 | $618,601 | $223,618 | $284,315 |
John Boehner | (R) | Yes | $1,290,680 | $505,300 | $303,225 | $189,550 | $292,605 |
Steny Hoyer | (D) | Yes | $1,285,286 | $225,055 | $588,920 | $220,050 | $251,261 |
Tom Price | (R) | Yes | $1,234,672 | $117,046 | $974,626 | $51,500 | $91,500 |
Nathan Deal | (R) | Yes | $1,217,519 | $177,050 | $550,550 | $109,300 | $380,619 |
Mark Kirk | (R) | No | $1,117,586 | $194,300 | $566,275 | $47,284 | $309,727 |
Robert Andrews | (D) | Yes | $1,092,699 | $329,850 | $530,449 | $105,950 | $126,450 |
Dave Camp | (R) | Yes | $1,087,501 | $258,327 | $447,669 | $116,958 | $264,547 |
Pete Sessions | (R) | No | $1,063,287 | $211,746 | $628,328 | $75,528 | $147,685 |
Ed Whitfield | (R) | Yes | $1,060,549 | $119,647 | $619,146 | $90,272 | $231,484 |
Edolphus Towns | (D) | Yes | $1,022,751 | $219,088 | $394,151 | $101,940 | $307,572 |
Here are some of the things the people who claim that public option will be affordable don't understand..
COSTS OF HAVING A CHRONIC ILLNESS
In particular, the biggest cost is prescription drugs and the often completely useless appointments doctors demand on having with you to refill them, EVEN WHEN ABSOLUTELY NOTHING HAS CHANGED.
These are fixed costs, and they are high. They are not something that happens and then you go a year with no costs.. they occur like clockwork..
That is why high deductible plans are NOT FEASIBLE for the chronically ill. THEY NEED THE HIGH END PLAN..because they need to have doctors visits and prescription drugs, or they rapidly slide into an emergency situation and often, can die.
some of us need to take five or six prescriptions, from three or four doctors. In order to get those prescriptions refilled (NOT TO TALK ABOUT ANY HEALTH ISSUES- THEY ARE "DRUG FOLLOW UP APPOINTMENTS" ONLY-!) I have to go in to doctors to talk to their assistants for five minutes and then to them for five minutes, for that they bill my insurance company around two or three hundred dollars a pop, say if each of those prescriptions costs $50=300 a month without insurance, or $25-$50 with insurance, AND there is a deductible, going to see three or four doctors, every three months, or they dont efill your RX's, (NO OTHER REASON)
CAN YOU SEE HOW IT STARTS TO ADD UP?
CAN YOU SEE HOW PEOPLE CAN'T AFFORD IT?
All of the "plans" being floated in Washington have a huge weakness in that they are so called "consumer driven" health plans. They trade cheapness, (they would say affordable, but most of these plans end up costing a lot of people a lot MORE money in the long run) for an unacceptable amount of risk.
Interview with consumer-driven health plan expert Timothy Jost, law professor at Washington and Lee University and author of Health Care at Risk: A Critique of the Consumer-Driven Movement, published in 2007.
Consumer-driven health care is a false promise
Senate Finance proposes unaffordable underinsurance
Cost Savings Myopia